School of Psychology, University of Waikato, Hamilton 3240, New Zealand.
Te Kupenga Hauora Māori, University of Auckland, Wellington 1010, New Zealand.
Int J Environ Res Public Health. 2020 Nov 27;17(23):8833. doi: 10.3390/ijerph17238833.
The predominant focus of Aotearoa New Zealand's public health system on biomedical models of health has left little room for meaningful engagement with holistic indigenous approaches. Culturally appropriate provision and support are recognized for their relevance and importance during hospital transferals. Hospital staff involved in transfers to one of New Zealand's trauma centers share their observations of whānau Māori engagement during an admission away from their home base. Sixteen key informants share their experiences, which are presented as strategies and challenges to whānau engagement. Three main themes highlight challenges within the health system that make it difficult for hospital staff to engage whānau in the desired ways and as often as both parties would like. Key informants described services and practices that are not designed with patients and their whānau in mind; instead they are designed by clinicians around the needs of administrative systems. As employees within the public health system, key informants felt powerless to challenge dominant settings. Nevertheless, employees managed to circumnavigate processes. Our findings highlight the need for continued decolonization and anti-racism work within public health settings.
新西兰的公共卫生系统主要关注生物医学模式的健康，几乎没有为与整体土著方法进行有意义的接触留出空间。在医院转院期间，人们认识到文化上适宜的服务和支持具有相关性和重要性。参与向新西兰创伤中心之一转院的医院工作人员分享了他们在远离家乡基地住院期间对毛利家庭参与的观察。16 名关键知情者分享了他们的经验，这些经验被呈现为与家庭接触的策略和挑战。三个主要主题突出了卫生系统内的挑战，这些挑战使得医院工作人员难以以双方都希望的方式和频率与家庭接触。关键知情者描述了那些不是为了患者及其家庭而设计的服务和做法；相反，它们是由临床医生围绕行政系统的需求设计的。作为公共卫生系统的员工，关键知情者感到无力挑战主导环境。然而，员工设法规避了流程。我们的研究结果强调了在公共卫生环境中继续进行非殖民化和反种族主义工作的必要性。
